| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
83,754 |
73,653 |
$14.23M |
| 99284 |
|
56,498 |
48,915 |
$9.54M |
| 99285 |
|
28,302 |
24,259 |
$4.92M |
| 41899 |
|
3,775 |
3,294 |
$4.59M |
| 96361 |
|
15,681 |
11,931 |
$4.21M |
| 43239 |
|
6,897 |
5,929 |
$3.32M |
| G0463 |
Hospital outpt clinic visit |
31,924 |
23,580 |
$2.71M |
| 74177 |
|
10,406 |
9,155 |
$2.43M |
| G0378 |
Hospital observation per hr |
14,062 |
8,586 |
$2.09M |
| 70450 |
|
11,872 |
10,308 |
$2.02M |
| 99282 |
|
12,887 |
11,451 |
$1.95M |
| 45380 |
|
2,884 |
2,499 |
$1.47M |
| 93306 |
|
4,532 |
3,855 |
$1.26M |
| 45378 |
|
1,620 |
1,478 |
$1.11M |
| 95810 |
|
1,710 |
1,585 |
$1.03M |
| 97110 |
|
22,551 |
7,075 |
$1.00M |
| 70553 |
|
3,054 |
2,772 |
$986K |
| 45385 |
|
1,467 |
1,285 |
$888K |
| 74176 |
|
4,364 |
3,713 |
$784K |
| 71275 |
|
3,077 |
2,722 |
$777K |
| 96360 |
|
5,588 |
4,882 |
$694K |
| 94640 |
|
10,932 |
6,544 |
$639K |
| 96366 |
|
3,192 |
1,873 |
$632K |
| 78815 |
|
827 |
715 |
$604K |
| 95811 |
|
1,135 |
1,001 |
$580K |
| 90791 |
|
3,724 |
3,184 |
$554K |
| 80053 |
|
102,047 |
86,363 |
$524K |
| 97161 |
|
6,101 |
5,293 |
$505K |
| 76705 |
|
5,245 |
4,733 |
$473K |
| 69436 |
|
427 |
331 |
$452K |
| 72148 |
|
2,573 |
2,344 |
$428K |
| 80307 |
|
9,643 |
8,242 |
$416K |
| 95806 |
|
750 |
709 |
$401K |
| 70551 |
|
1,930 |
1,722 |
$394K |
| 95819 |
|
1,598 |
1,526 |
$392K |
| 76700 |
|
2,820 |
2,653 |
$382K |
| 96365 |
|
4,926 |
4,147 |
$367K |
| U0003 |
Cov-19 amp prb hgh thruput |
12,448 |
11,706 |
$338K |
| 77067 |
|
6,902 |
6,624 |
$321K |
| 87635 |
|
6,488 |
5,835 |
$308K |
| 78452 |
|
531 |
425 |
$283K |
| 76856 |
|
2,910 |
2,605 |
$279K |
| 71046 |
|
26,122 |
23,422 |
$279K |
| 99281 |
|
1,780 |
1,638 |
$274K |
| 70496 |
|
1,066 |
950 |
$270K |
| 93971 |
|
2,663 |
2,326 |
$243K |
| 84443 |
|
25,889 |
23,412 |
$240K |
| 76642 |
|
2,313 |
1,918 |
$238K |
| 80061 |
|
38,669 |
34,952 |
$235K |
| 0202U |
|
1,985 |
1,848 |
$229K |
| C1713 |
Anchor/screw bn/bn,tis/bn |
2,273 |
1,852 |
$225K |
| 82306 |
|
13,995 |
12,488 |
$222K |
| 73721 |
|
1,099 |
991 |
$220K |
| 43235 |
|
374 |
330 |
$216K |
| 94010 |
|
3,574 |
3,374 |
$206K |
| 76816 |
|
3,955 |
3,438 |
$200K |
| 72141 |
|
1,134 |
1,032 |
$192K |
| 76536 |
|
1,692 |
1,585 |
$191K |
| 97140 |
|
13,102 |
4,552 |
$187K |
| 83036 |
|
35,432 |
31,806 |
$186K |
| 85025 |
|
89,987 |
73,714 |
$168K |
| 74018 |
|
7,641 |
6,843 |
$148K |
| J2704 |
Inj, propofol, 10 mg |
32,013 |
25,297 |
$148K |
| 76819 |
|
2,512 |
1,456 |
$148K |
| 76830 |
|
2,308 |
2,054 |
$147K |
| 76770 |
|
1,198 |
1,087 |
$135K |
| 36415 |
|
136,358 |
107,461 |
$128K |
| 76817 |
|
1,894 |
1,653 |
$124K |
| 80048 |
|
21,719 |
17,076 |
$117K |
| 87389 |
|
9,841 |
8,881 |
$116K |
| 86803 |
|
11,279 |
10,208 |
$114K |
| 97112 |
|
4,371 |
1,660 |
$114K |
| 87801 |
|
3,721 |
3,255 |
$113K |
| 70491 |
|
548 |
485 |
$112K |
| 11042 |
|
788 |
415 |
$111K |
| 93798 |
|
1,086 |
184 |
$111K |
| 42820 |
|
96 |
75 |
$109K |
| 93005 |
|
36,493 |
30,305 |
$107K |
| 95816 |
|
531 |
465 |
$106K |
| 93970 |
|
892 |
785 |
$106K |
| G0330 |
Facility svs dental rehab |
61 |
61 |
$106K |
| 74183 |
|
321 |
298 |
$104K |
| 85027 |
|
25,995 |
22,516 |
$104K |
| 97116 |
|
3,698 |
1,931 |
$98K |
| 97162 |
|
669 |
613 |
$97K |
| 71250 |
|
1,500 |
1,319 |
$96K |
| 12011 |
|
430 |
400 |
$88K |
| 97530 |
|
3,041 |
1,474 |
$84K |
| 87591 |
|
6,689 |
5,890 |
$84K |
| 77072 |
|
1,486 |
1,431 |
$83K |
| 80050 |
|
7,808 |
6,991 |
$83K |
| 84439 |
|
9,827 |
8,870 |
$81K |
| 77063 |
|
3,232 |
3,120 |
$80K |
| 76811 |
|
989 |
915 |
$78K |
| 12001 |
|
393 |
369 |
$77K |
| 72125 |
|
2,132 |
1,851 |
$76K |
| 97014 |
|
2,561 |
1,049 |
$73K |
| 70498 |
|
1,231 |
1,098 |
$71K |
| 77080 |
|
1,148 |
1,081 |
$71K |
| 97165 |
|
1,637 |
1,333 |
$69K |
| 99395 |
|
477 |
450 |
$68K |
| 72100 |
|
3,800 |
3,428 |
$66K |
| 71260 |
|
1,530 |
1,363 |
$63K |
| 83880 |
|
5,532 |
4,596 |
$62K |
| 99396 |
|
562 |
516 |
$62K |
| 76801 |
|
1,960 |
1,752 |
$61K |
| 88305 |
|
13,115 |
10,662 |
$60K |
| 99204 |
|
421 |
374 |
$58K |
| 95800 |
|
357 |
340 |
$56K |
| 82607 |
|
5,750 |
5,085 |
$53K |
| 97535 |
|
2,330 |
1,588 |
$52K |
| 97016 |
|
2,013 |
738 |
$51K |
| 82728 |
|
5,638 |
5,032 |
$51K |
| 74240 |
|
487 |
466 |
$50K |
| 95714 |
|
146 |
98 |
$50K |
| G0379 |
Direct refer hospital observ |
326 |
268 |
$49K |
| 97803 |
|
549 |
454 |
$49K |
| 87491 |
|
6,640 |
5,838 |
$48K |
| 87086 |
|
17,026 |
14,805 |
$47K |
| 58571 |
|
20 |
12 |
$47K |
| 77065 |
Tomosynthesis, mammo |
1,330 |
1,125 |
$46K |
| 93017 |
|
773 |
639 |
$45K |
| 47562 |
|
17 |
12 |
$44K |
| 73562 |
|
4,182 |
3,135 |
$43K |
| 73221 |
|
216 |
195 |
$41K |
| 77066 |
Tomosynthesis, mammo |
1,259 |
1,142 |
$41K |
| U0005 |
Infec agen detec ampli probe |
10,745 |
10,124 |
$40K |
| 99218 |
|
3,587 |
1,733 |
$40K |
| 87040 |
|
5,788 |
3,320 |
$40K |
| 70486 |
|
658 |
609 |
$39K |
| 81001 |
|
46,201 |
39,885 |
$35K |
| 76870 |
|
363 |
326 |
$33K |
| 71271 |
|
335 |
314 |
$32K |
| 83550 |
|
5,917 |
5,311 |
$32K |
| 94060 |
|
428 |
409 |
$31K |
| 76815 |
|
728 |
636 |
$31K |
| 82570 |
|
7,725 |
6,977 |
$31K |
| G0480 |
Drug test def 1-7 classes |
915 |
722 |
$30K |
| 73030 |
|
2,509 |
2,179 |
$30K |
| 73130 |
|
2,140 |
1,712 |
$28K |
| J2405 |
Ondansetron hcl injection |
35,904 |
25,573 |
$28K |
| 86780 |
|
2,854 |
2,611 |
$28K |
| 76805 |
|
353 |
317 |
$28K |
| 84484 |
|
23,284 |
16,066 |
$27K |
| 82962 |
|
24,385 |
9,829 |
$26K |
| 95812 |
|
43 |
43 |
$26K |
| 73630 |
|
2,827 |
2,364 |
$26K |
| 72050 |
|
1,066 |
971 |
$25K |
| 87340 |
|
4,447 |
4,010 |
$25K |
| J7030 |
Normal saline solution infus |
39,476 |
30,393 |
$25K |
| 99385 |
|
176 |
168 |
$24K |
| 83540 |
|
6,150 |
5,515 |
$24K |
| 85379 |
|
5,181 |
4,578 |
$23K |
| 93308 |
|
92 |
82 |
$23K |
| 72131 |
|
320 |
299 |
$22K |
| 84153 |
|
2,024 |
1,841 |
$22K |
| 71045 |
|
12,393 |
10,521 |
$20K |
| 99203 |
|
155 |
138 |
$20K |
| 86850 |
|
6,571 |
5,777 |
$20K |
| 74241 |
|
186 |
169 |
$20K |
| 82043 |
|
7,211 |
6,608 |
$20K |
| C8908 |
Mri w/o fol w/cont, breast, |
47 |
41 |
$19K |
| 88307 |
|
1,571 |
1,165 |
$19K |
| 86592 |
|
3,652 |
3,248 |
$19K |
| 87661 |
|
1,494 |
1,305 |
$18K |
| 82746 |
|
2,878 |
2,495 |
$17K |
| 87522 |
Neg quan hep c or qual rna |
718 |
622 |
$16K |
| J3490 |
Drugs unclassified injection |
26,212 |
11,295 |
$16K |
| 73502 |
|
1,529 |
1,348 |
$16K |
| 96374 |
|
29,060 |
24,587 |
$16K |
| G0103 |
Psa screening |
1,539 |
1,369 |
$16K |
| 80076 |
|
3,036 |
2,696 |
$15K |
| S9472 |
Cardiac rehabilitation progr |
151 |
25 |
$15K |
| 87636 |
|
4,361 |
4,110 |
$15K |
| 84403 |
|
1,135 |
1,011 |
$15K |
| 73610 |
|
2,609 |
2,304 |
$15K |
| J0131 |
Inj, acetaminophen (nos) |
2,828 |
2,325 |
$14K |
| 0042T |
|
73 |
65 |
$14K |
| 84702 |
|
4,154 |
3,395 |
$14K |
| J1885 |
Ketorolac tromethamine inj |
27,101 |
21,370 |
$14K |
| 90715 |
|
824 |
735 |
$13K |
| 87070 |
|
11,847 |
10,390 |
$13K |
| 76882 |
|
143 |
129 |
$13K |
| 87798 |
|
560 |
455 |
$12K |
| 83735 |
|
13,614 |
10,611 |
$12K |
| 85610 |
|
8,680 |
6,919 |
$12K |
| 93458 |
|
16 |
13 |
$12K |
| G0279 |
Tomosynthesis, mammo |
543 |
495 |
$12K |
| 99212 |
|
431 |
357 |
$12K |
| 10060 |
|
140 |
118 |
$11K |
| 81025 |
|
24,268 |
20,866 |
$11K |
| 86900 |
|
6,846 |
6,010 |
$11K |
| 86038 |
|
1,418 |
1,235 |
$11K |
| 76820 |
|
277 |
141 |
$11K |
| 84402 |
|
758 |
674 |
$11K |
| 86140 |
|
5,434 |
4,716 |
$11K |
| 45384 |
|
17 |
14 |
$10K |
| 86706 |
|
1,880 |
1,660 |
$10K |
| 83001 |
|
819 |
745 |
$10K |
| 70360 |
|
452 |
435 |
$10K |
| 87077 |
|
6,067 |
5,025 |
$10K |
| 84145 |
|
1,348 |
1,157 |
$10K |
| 80074 |
|
631 |
563 |
$10K |
| 76818 |
|
112 |
65 |
$10K |
| 82784 |
|
1,356 |
1,173 |
$9K |
| 90674 |
|
373 |
344 |
$9K |
| 88304 |
|
2,058 |
1,772 |
$9K |
| 99213 |
|
253 |
204 |
$9K |
| 90714 |
|
419 |
391 |
$9K |
| 76885 |
|
78 |
69 |
$9K |
| 87186 |
|
5,663 |
4,716 |
$9K |
| 74019 |
|
2,629 |
2,405 |
$9K |
| 86762 |
|
1,586 |
1,460 |
$9K |
| 86376 |
|
676 |
612 |
$9K |
| 84146 |
|
673 |
608 |
$8K |
| 86704 |
|
1,150 |
1,014 |
$8K |
| 76937 |
|
581 |
478 |
$8K |
| G0400 |
Home sleep test/type 4 porta |
89 |
83 |
$8K |
| 85652 |
|
5,304 |
4,682 |
$8K |
| 82107 |
|
340 |
296 |
$8K |
| 90661 |
|
275 |
268 |
$8K |
| 83690 |
|
18,655 |
15,849 |
$8K |
| J2370 |
Phenylephrine hcl injection |
4,666 |
3,115 |
$8K |
| 83020 |
|
1,072 |
985 |
$8K |
| 87804 |
|
18,352 |
8,517 |
$8K |
| 83002 |
|
739 |
671 |
$7K |
| 87081 |
|
1,176 |
1,091 |
$7K |
| 86901 |
|
6,842 |
6,008 |
$7K |
| 86787 |
|
1,458 |
1,317 |
$7K |
| 83605 |
|
4,660 |
3,524 |
$7K |
| 72197 |
|
27 |
25 |
$6K |
| 96375 |
|
18,629 |
14,548 |
$6K |
| U0002 |
Covid-19 lab test non-cdc |
948 |
761 |
$6K |
| 83721 |
|
967 |
867 |
$6K |
| 87150 |
|
255 |
239 |
$6K |
| 87880 |
|
9,936 |
8,822 |
$6K |
| 82950 |
|
1,640 |
1,541 |
$6K |
| 83520 |
|
591 |
536 |
$6K |
| 90471 |
|
2,049 |
1,835 |
$6K |
| 73110 |
|
892 |
809 |
$6K |
| 74230 |
|
72 |
66 |
$6K |
| 83516 |
|
529 |
448 |
$6K |
| 82550 |
|
3,983 |
3,146 |
$6K |
| 86480 |
|
477 |
419 |
$6K |
| Q9967 |
Locm 300-399mg/ml iodine,1ml |
20,431 |
17,199 |
$6K |
| 80179 |
|
1,930 |
1,713 |
$6K |
| 72072 |
|
402 |
366 |
$6K |
| 70310 |
|
2,697 |
2,404 |
$6K |
| 70544 |
|
15 |
15 |
$5K |
| 80143 |
|
1,953 |
1,745 |
$5K |
| 84703 |
|
3,153 |
2,829 |
$5K |
| 64415 |
|
26 |
17 |
$5K |
| 88342 |
|
2,406 |
1,879 |
$5K |
| J2250 |
Inj midazolam hydrochloride |
15,237 |
11,268 |
$5K |
| 73590 |
|
774 |
657 |
$5K |
| 87506 |
|
148 |
131 |
$5K |
| J1100 |
Dexamethasone sodium phos |
20,932 |
17,391 |
$5K |
| G0008 |
Admin influenza virus vac |
1,168 |
1,019 |
$5K |
| 80047 |
|
1,079 |
892 |
$5K |
| 99152 |
|
2,082 |
1,661 |
$5K |
| 85018 |
|
2,908 |
2,152 |
$5K |
| 84480 |
|
590 |
529 |
$5K |
| 96372 |
|
14,071 |
9,681 |
$5K |
| 87147 |
|
2,955 |
2,429 |
$4K |
| J3010 |
Fentanyl citrate injection |
22,319 |
14,104 |
$4K |
| J0690 |
Cefazolin sodium injection |
10,726 |
6,662 |
$4K |
| 84550 |
|
1,637 |
1,417 |
$4K |
| J7120 |
Ringers lactate infusion |
21,616 |
15,960 |
$4K |
| 86200 |
|
513 |
456 |
$4K |
| 81003 |
|
3,270 |
2,878 |
$4K |
| 86235 |
|
107 |
86 |
$4K |
| 99153 |
Mod sedat endo service >5yrs |
1,250 |
1,002 |
$4K |
| 77061 |
|
162 |
156 |
$4K |
| 73140 |
|
776 |
706 |
$4K |
| 84436 |
|
535 |
451 |
$3K |
| 85730 |
|
3,225 |
2,681 |
$3K |
| 77062 |
|
175 |
169 |
$3K |
| 86696 |
|
382 |
325 |
$3K |
| 86431 |
|
670 |
597 |
$3K |
| J1200 |
Diphenhydramine hcl injectio |
4,967 |
4,029 |
$3K |
| 96367 |
|
156 |
115 |
$3K |
| 82172 |
|
313 |
266 |
$3K |
| 90686 |
|
383 |
301 |
$3K |
| 86141 |
|
365 |
322 |
$3K |
| 96376 |
|
8,685 |
4,371 |
$3K |
| 92611 |
|
58 |
54 |
$3K |
| 86800 |
|
314 |
278 |
$3K |
| J1815 |
Insulin injection |
1,458 |
452 |
$2K |
| 95886 |
|
29 |
29 |
$2K |
| 83970 |
|
91 |
81 |
$2K |
| 97802 |
|
130 |
116 |
$2K |
| J1650 |
Inj enoxaparin sodium |
3,937 |
1,685 |
$2K |
| C1776 |
Joint device (implantable) |
113 |
83 |
$2K |
| 83021 |
|
124 |
118 |
$2K |
| 86695 |
|
286 |
244 |
$2K |
| 82670 |
|
168 |
147 |
$2K |
| 88341 |
|
319 |
211 |
$2K |
| 82553 |
|
476 |
331 |
$2K |
| 84100 |
|
3,178 |
2,244 |
$2K |
| A9500 |
Tc99m sestamibi |
626 |
452 |
$2K |
| J1170 |
Hydromorphone injection |
9,057 |
5,183 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
5,079 |
3,762 |
$2K |
| 87521 |
Neg quan hep c or qual rna |
89 |
73 |
$2K |
| 82803 |
|
1,981 |
1,534 |
$2K |
| G0399 |
Home sleep test/type 3 porta |
28 |
22 |
$2K |
| 82247 |
|
498 |
304 |
$2K |
| 73080 |
|
479 |
434 |
$2K |
| 82077 |
|
3,354 |
2,899 |
$2K |
| J1644 |
Inj heparin sodium per 1000u |
4,853 |
2,042 |
$2K |
| 72040 |
|
167 |
159 |
$2K |
| 86003 |
|
78 |
69 |
$2K |
| G0283 |
Elec stim other than wound |
51 |
21 |
$2K |
| 0100U |
|
80 |
64 |
$2K |
| 84156 |
|
905 |
749 |
$2K |
| G0108 |
Diab manage trn per indiv |
72 |
58 |
$2K |
| 86364 |
|
502 |
447 |
$2K |
| C1889 |
Implant/insert device, noc |
79 |
65 |
$2K |
| 80069 |
|
320 |
251 |
$2K |
| 82465 |
|
345 |
333 |
$1K |
| 90694 |
|
130 |
110 |
$1K |
| 87210 |
|
3,605 |
2,867 |
$1K |
| 80164 |
|
240 |
213 |
$1K |
| 87205 |
|
1,934 |
1,565 |
$1K |
| 87634 |
|
711 |
678 |
$1K |
| 82951 |
|
121 |
111 |
$1K |
| 93291 |
|
48 |
40 |
$1K |
| 73700 |
|
13 |
12 |
$1K |
| 83615 |
|
596 |
502 |
$1K |
| J8540 |
Oral dexamethasone |
297 |
236 |
$1K |
| 84425 |
|
172 |
155 |
$1K |
| 81002 |
|
536 |
484 |
$1K |
| 95012 |
|
30 |
27 |
$1K |
| J2765 |
Metoclopramide hcl injection |
1,541 |
1,207 |
$1K |
| 85014 |
|
648 |
475 |
$1K |
| 84165 |
|
166 |
147 |
$1K |
| 80177 |
|
208 |
181 |
$983.94 |
| 76942 |
|
22 |
17 |
$965.11 |
| 87088 |
|
397 |
373 |
$951.98 |
| 99214 |
|
29 |
27 |
$886.24 |
| 83655 |
|
76 |
72 |
$874.25 |
| 94762 |
|
327 |
255 |
$856.26 |
| 73560 |
|
48 |
42 |
$835.11 |
| C1769 |
Guide wire |
2,451 |
1,921 |
$823.10 |
| J7050 |
Normal saline solution infus |
5,290 |
3,590 |
$808.31 |
| 87633 |
|
17 |
16 |
$796.50 |
| 51798 |
|
53 |
39 |
$788.11 |
| 93225 |
|
17 |
14 |
$784.22 |
| J7512 |
Prednisone ir or dr oral 1mg |
1,238 |
938 |
$745.38 |
| 10061 |
|
16 |
14 |
$742.95 |
| 93296 |
|
181 |
127 |
$741.46 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
599 |
509 |
$713.49 |
| 82150 |
|
136 |
130 |
$693.72 |
| 87807 |
|
2,396 |
2,266 |
$680.93 |
| 0099U |
|
54 |
49 |
$677.83 |
| 86334 |
|
67 |
61 |
$662.06 |
| 90653 |
|
147 |
115 |
$661.59 |
| J0330 |
Succinycholine chloride inj |
5,310 |
4,271 |
$650.26 |
| 86225 |
|
108 |
90 |
$633.72 |
| 36416 |
|
688 |
550 |
$627.83 |
| 36600 |
|
96 |
78 |
$562.40 |
| J7040 |
Normal saline solution infus |
4,292 |
3,278 |
$542.04 |
| J2270 |
Morphine sulfate injection |
5,452 |
3,826 |
$524.59 |
| 73090 |
|
320 |
287 |
$512.20 |
| 84132 |
|
744 |
666 |
$502.11 |
| 82627 |
|
29 |
26 |
$502.06 |
| 82105 |
|
32 |
31 |
$483.58 |
| J0780 |
Prochlorperazine injection |
3,164 |
2,517 |
$483.34 |
| J3480 |
Inj potassium chloride |
3,528 |
1,972 |
$481.55 |
| 86708 |
|
87 |
69 |
$463.97 |
| 85660 |
|
134 |
125 |
$436.75 |
| 82140 |
|
109 |
87 |
$420.42 |
| J2001 |
Lidocaine injection |
3,674 |
2,866 |
$383.47 |
| 82330 |
|
437 |
391 |
$379.46 |
| 97760 |
|
15 |
12 |
$378.16 |
| 82952 |
|
121 |
111 |
$363.48 |
| 82565 |
|
255 |
210 |
$330.17 |
| J2795 |
Ropivacaine hcl injection |
1,315 |
1,000 |
$303.78 |
| 83498 |
|
15 |
15 |
$297.16 |
| 86231 |
|
102 |
98 |
$282.48 |
| 86258 |
|
78 |
60 |
$281.65 |
| 85045 |
|
170 |
152 |
$275.91 |
| 83695 |
|
28 |
28 |
$275.00 |
| 82977 |
|
56 |
53 |
$258.46 |
| J2060 |
Lorazepam injection |
1,414 |
936 |
$233.17 |
| 87486 |
|
17 |
16 |
$230.52 |
| 82248 |
|
140 |
107 |
$227.02 |
| 84481 |
|
42 |
39 |
$219.80 |
| G0444 |
Depression screen annual |
78 |
42 |
$218.88 |
| 84681 |
|
17 |
15 |
$217.76 |
| 85007 |
|
953 |
847 |
$212.33 |
| J2710 |
Neostigmine methylslfte inj |
3,098 |
2,461 |
$211.73 |
| C9113 |
Inj pantoprazole sodium, via |
2,592 |
1,241 |
$193.20 |
| 93797 |
|
58 |
25 |
$167.88 |
| 82947 |
|
338 |
303 |
$164.61 |
| 82785 |
|
12 |
12 |
$163.63 |
| 86015 |
|
29 |
25 |
$159.18 |
| J0561 |
Penicillin g benzathine inj |
16 |
15 |
$156.24 |
| 86677 |
|
13 |
13 |
$153.00 |
| 86308 |
|
216 |
194 |
$135.75 |
| J3475 |
Inj magnesium sulfate |
833 |
670 |
$134.87 |
| 83521 |
|
12 |
12 |
$124.63 |
| 73620 |
|
17 |
12 |
$123.51 |
| 86665 |
|
15 |
14 |
$118.99 |
| 82272 |
|
628 |
545 |
$118.69 |
| 86735 |
|
19 |
15 |
$118.54 |
| 87581 |
|
17 |
16 |
$115.31 |
| 99497 |
|
46 |
40 |
$113.28 |
| A9576 |
Inj prohance multipack |
1,515 |
1,373 |
$113.08 |
| 51701 |
|
475 |
398 |
$111.41 |
| J0500 |
Dicyclomine injection |
185 |
162 |
$109.98 |
| 83718 |
|
12 |
12 |
$90.47 |
| 82390 |
|
14 |
13 |
$78.66 |
| 86765 |
|
19 |
15 |
$78.54 |
| J2175 |
Meperidine hydrochl /100 mg |
781 |
627 |
$73.83 |
| 71101 |
|
13 |
12 |
$72.27 |
| 87651 |
|
409 |
400 |
$66.32 |
| 74022 |
|
53 |
49 |
$64.25 |
| J2930 |
Methylprednisolone injection |
727 |
523 |
$60.48 |
| 73660 |
|
29 |
29 |
$59.59 |
| 73552 |
|
32 |
27 |
$48.17 |
| 88271 |
|
15 |
12 |
$44.12 |
| J7510 |
Prednisolone oral per 5 mg |
281 |
229 |
$41.06 |
| 86664 |
|
15 |
14 |
$40.21 |
| C1894 |
Intro/sheath, non-laser |
1,693 |
1,390 |
$36.10 |
| 94664 |
|
362 |
334 |
$33.67 |
| 84295 |
|
234 |
203 |
$30.45 |
| J3370 |
Vancomycin hcl injection |
692 |
319 |
$30.29 |
| 90472 |
|
13 |
13 |
$28.55 |
| 87045 |
|
27 |
25 |
$26.88 |
| 87427 |
|
28 |
26 |
$26.83 |
| A9552 |
F18 fdg |
719 |
630 |
$26.52 |
| J2550 |
Promethazine hcl injection |
87 |
63 |
$21.18 |
| J0360 |
Hydralazine hcl injection |
346 |
237 |
$19.93 |
| J0665 |
Inj, bupivacaine, nos, 0.5mg |
1,357 |
1,119 |
$15.00 |
| J2371 |
Inj phenylephrine hcl 20 mcg |
1,628 |
1,118 |
$15.00 |
| J2543 |
Piperacillin/tazobactam |
799 |
238 |
$14.70 |
| 87899 |
|
28 |
26 |
$13.44 |
| 87046 |
|
27 |
25 |
$13.44 |
| 94760 |
|
1,964 |
1,327 |
$12.50 |
| 82657 |
|
480 |
229 |
$12.08 |
| A9575 |
Inj gadoterate meglumi 0.1ml |
1,617 |
1,458 |
$7.90 |
| L1830 |
Ko immob canvas long pre ots |
54 |
50 |
$7.32 |
| J3411 |
Thiamine hcl 100 mg |
35 |
25 |
$4.36 |
| J2920 |
Methylprednisolone injection |
81 |
41 |
$4.32 |
| A4565 |
Slings |
245 |
191 |
$3.83 |
| J2919 |
Inj, methylpred sod succ 5mg |
146 |
94 |
$3.65 |
| J1630 |
Haloperidol injection |
51 |
49 |
$3.45 |
| J0461 |
Atropine sulfate injection |
14 |
13 |
$2.34 |
| J8597 |
Antiemetic drug oral nos |
15 |
14 |
$2.34 |
| J1642 |
Inj heparin sodium per 10 u |
15 |
12 |
$1.64 |
| J0171 |
Adrenalin epinephrine inject |
57 |
50 |
$1.34 |
| J3360 |
Diazepam injection |
42 |
37 |
$0.54 |
| Q0162 |
Ondansetron oral |
1,877 |
1,749 |
$0.04 |
| G8979 |
Mobility goal status |
333 |
210 |
$0.00 |
| G8978 |
Mobility current status |
310 |
201 |
$0.00 |
| A4216 |
Sterile water/saline, 10 ml |
333 |
151 |
$0.00 |
| C1751 |
Cath, inf, per/cent/midline |
13 |
12 |
$0.00 |
| J1598 |
Inj glycopyrrolate fres kabi |
33 |
33 |
$0.00 |
| J1596 |
Inj, glycopyrrolate, 0.1 mg |
436 |
376 |
$0.00 |
| J2272 |
Inj, morphine (fresenius) |
397 |
282 |
$0.00 |
| J0688 |
Inj cefazolin sodium, hikma |
1,054 |
887 |
$0.00 |
| J0694 |
Cefoxitin sodium injection |
117 |
88 |
$0.00 |
| C1887 |
Catheter, guiding |
126 |
105 |
$0.00 |
| J1171 |
Inj, hydromorphone, 0.1 mg |
164 |
111 |
$0.00 |
| J2004 |
Inj, lidocaine w epinephrine |
23 |
23 |
$0.00 |
| J1953 |
Levetiracetam injection |
58 |
38 |
$0.00 |
| 69210 |
|
12 |
12 |
$0.00 |
| J0670 |
Inj mepivacaine hcl/10 ml |
76 |
52 |
$0.00 |
| C1760 |
Closure dev, vasc |
13 |
12 |
$0.00 |
| 76000 |
|
14 |
12 |
$0.00 |
| 96138 |
|
12 |
12 |
$0.00 |
| Q9957 |
Inj perflutren lip micros,ml |
14 |
13 |
$0.00 |
| A9585 |
Gadobutrol injection |
593 |
535 |
$0.00 |
| A9609 |
F18 fdg, 15 millicuries |
70 |
52 |
$0.00 |
| J1836 |
Inj, metronidazole, 10 mg |
234 |
130 |
$0.00 |
| C9290 |
Inj, bupivacaine liposome |
310 |
253 |
$0.00 |
| A9270 |
Non-covered item or service |
3,968 |
848 |
$0.00 |
| A9579 |
Gad-base mr contrast nos,1ml |
1,413 |
1,243 |
$0.00 |
| J2785 |
Regadenoson injection |
339 |
279 |
$0.00 |
| J1790 |
Droperidol injection |
123 |
104 |
$0.00 |
| J2470 |
Inj pantoprazole sodium 40mg |
199 |
120 |
$0.00 |
| 87637 |
|
112 |
110 |
$0.00 |
| G8980 |
Mobility d/c status |
35 |
24 |
$0.00 |
| 88300 |
|
87 |
75 |
$0.00 |
| A9503 |
Tc99m medronate |
15 |
13 |
$0.00 |
| S2900 |
Robotic surgical system |
198 |
147 |
$0.00 |
| J1940 |
Furosemide injection |
18 |
12 |
$0.00 |
| C1781 |
Mesh (implantable) |
31 |
26 |
$0.00 |
| 94761 |
|
110 |
69 |
$0.00 |
| C9399 |
Unclassified drugs or biolog |
77 |
59 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
175 |
169 |
$0.00 |
| G8987 |
Self care current status |
21 |
13 |
$0.00 |
| C1892 |
Intro/sheath,fixed,peel-away |
16 |
12 |
$0.00 |
| 70300 |
|
27 |
24 |
$0.00 |
| G8988 |
Self care goal status |
21 |
13 |
$0.00 |